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Homeless patients cost $2,500 more per hospital stay, study finds

Paramedics in the emergency-room entrance at St. Michael's Hospital in Toronto.

Fred Lum/The Globe and Mail/Fred Lum/The Globe and Mail

Homeless patients cost hospitals an extra $2,500, largely because they have underlying health problems and stay longer, a new study suggests.

The research found that hospital stays by the homeless cost an average of $2,559 more than for other patients - "a substantial impact on the health care system," Stephen Hwang, lead author of the study and a physician at St. Michael's Hospital in Toronto, said in a release.

Dr. Hwang compared data for 3,081 homeless patients and 90,345 patients from the general population who were admitted to St. Mike's over a five-year period. He adjusted the data for age, sex and severity of illness.

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The study, which is published in the March issue of Medical Care, found that homeless patients arrived at the hospital with more health problems and stayed longer, often because there was nowhere to send them after they no longer needed acute care.

Dr. Hwang's past research found that homeless people land in hospital more often, with 23 hospitalizations per 100 homeless people in one year versus five hospitalizations per 100 people in the general population.

The higher costs for hospitalizing homeless people with psychiatric problems is probably due to the severity of their illness when they are admitted, Dr. Hwang said. This could reflect both the limited availability of mental health services for the homeless in the community and the necessity to have severe symptoms to be hospitalized.

"Assertive outreach through community mental health programs may lower costs by preventing or reducing the duration of psychiatric hospitalizations among homeless people," he said.

On Monday, the Mental Health Commission of Canada, which is conducting a related study on the links between mental health and homelessness, said early results indicate patients do better when they have a roof over their heads.

The federal funded study theorizes the ""housing first, recovery will follow" strategy will lead to positive signs of rehabilitation.

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